Wang Zhenfei, Huang Sen, Xu Long, Bu Jinhui, Liu Guangpu, Wang Hui, Liang Jun, Xia Mengjiao, Chen Tao, Ma Chao, Dai Kerong, Liu Guangwang
Department of Orthopedic Surgery, XuZhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, XuZhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, The Xuzhou School of Clinical Medicine of Nanjing Medical University, XuZhou Central Hospital Affiliated to Medical School of Southeast University, Xuzhou, China.
XuZhou Clinical School of Xuzhou Medical University, Xuzhou, China.
Front Surg. 2022 Oct 25;9:1011746. doi: 10.3389/fsurg.2022.1011746. eCollection 2022.
Full-endoscopic discectomy is associated with a high risk of disc reherniation due to the poor mechanical strength of the annulus fibrosus after scar healing. It is technically difficult to place a full-endoscopic annulus fibrosus suture. We designed an annulus fibrosus suture device that can be used to suture annulus defects under microendoscopy. The present study investigated the safety and feasibility of this technology.
We retrospectively analyzed the outcomes of patients who underwent surgical treatment for lumbar disc herniation (LDH) from January 2018 to October 2020. We compared 40 patients with LDH treated with full-endoscopic annulus fibrosus suture following lumbar discectomy (LD + AFS group) with 42 patients treated with lumbar discectomy alone (LD group) regarding demographic data, symptoms, and recurrence and reoperation rates. Lumbar MRI and CT were performed 3 and 12 months. A 10-point visual analog scale (VAS) and the Oswestry Disability Index (ODI) was used to evaluate pain and the lumbar spine function.
The cohort comprised 82 patients, including 40 patients in the LD + AFS group and 42 in the LD group. All operations were successfully completed without serious complications. Reherniation occurred in no patients in the LD + AFS group and three patients in the LD group. The VAS scores for lumbar and leg pain and ODI score were significantly improved postoperatively (< 0.05).
Compared with conventional lumbar discectomy, full-endoscopic annulus fibrosus suture following full-endoscopic lumbar discectomy is a safe and effective minimally invasive technique that reduces the LDH recurrence rate.
由于瘢痕愈合后纤维环机械强度差，全内镜下椎间盘切除术与椎间盘再突出的高风险相关。全内镜下纤维环缝合在技术上具有挑战性。我们设计了一种可用于在显微内镜下缝合纤维环缺损的纤维环缝合装置。本研究探讨了该技术的安全性和可行性。
我们回顾性分析了2018年1月至2020年10月接受腰椎间盘突出症（LDH）手术治疗的患者的结果。我们比较了40例行全内镜下腰椎间盘切除术后纤维环缝合的LDH患者（LD + AFS组）和42例仅行腰椎间盘切除术的患者（LD组）的人口统计学数据、症状以及复发和再次手术率。在术后3个月和12个月进行腰椎MRI和CT检查。采用10分视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评估疼痛和腰椎功能。
该队列包括82例患者，其中LD + AFS组40例，LD组42例。所有手术均成功完成，无严重并发症。LD + AFS组无患者发生再突出，LD组有3例患者发生再突出。术后腰椎和腿部疼痛的VAS评分以及ODI评分均有显著改善（<0.05）。
与传统腰椎间盘切除术相比，全内镜下腰椎间盘切除术后全内镜下纤维环缝合是一种安全有效的微创技术，可降低LDH复发率。
